Imaging of head and neck lipoblastoma: case report and systematic review

An Unusual Paediatric Neck Mass: Cervical Lipoblastoma with Spinal Involvement

Lipoblastoma is a benign tumour derived from embryonic white fat and is more commonly seen in children. Spinal involvement is rare, with only 14 cases reported to date. We report a case of a 7-year-old boy who was presented with an asymptomatic right neck swelling for 5 years. Clinical examination revealed a soft multilobulated mass causing tracheal deviation with normal neurological examination. Ultrasound, Computed tomography and Magnetic resonance imaging showed a lipomatous lesion with extension to spinal foramina at C3-C5 causing displacement of the spinal cord. Near total excision of the tumour was done with a small remnant left behind at C3-C4 as it was tightly adhered to the vertebral artery. Histopathological samples were consistent with lipoblastoma. The patient developed ipsilateral ptosis and pupillary myosis which improved on the second-month postoperative review; no other neurological deficit was noted, and a follow-up cervical MRI showed no recurrence.

A case of lipoblastoma in a pediatric patient

Lipoblastoma is a benign soft tissue tumor that originates from embryonic white fat. Lipoblastoma presents as a slow-growing mass that commonly occurs in the extremities of young children. Histological examination remains the gold standard in confirming lipoblastoma; however, radiology examination can help identify and evaluate the extent and characterization of the mass prior to the excision. Here, we report a 7-year-old male patient who presented with a painless mass in the right popliteal extending to the proximal cruris areas, and the imaging modalities suggested the presence of fat within the mass. The patient then underwent complete excision, and histopathology examination revealed lipoblastoma. This study highlights the possibility of lipoblastoma in older children and the role of imaging examinations in the diagnosis.

Head and neck lipoblastoma in children: A case report and systematic review

BACKGROUND

Lipoblastoma is a rare and benign tumor arising from embryonal fat cells. It develops primarily in infancy and early childhood. We present a case study of a 10-month-old child treated for an extensive tumor of the infratemporal fossa and parapharyngeal space. The systematic review of 60 reports in 80 children with lipoblastoma of the head and neck is also reported.

MATERIAL AND METHODS

Systematic review of all articles included lipoblastomas of the head and neck area in children published from 1964 to 2022 in the PubMed database was conducted. Clinical presentation of extensive lipoblastoma of the head and neck in a child.

RESULTS

On the basis of all inclusion criteria 83 articles were identified concerning pediatric lipoblastoma. There were 36 F (45%) and 39 M (48%), in 6 patients, (7%) gender was not specified. Ages ranged from 0mth (6h) to 15 yo (180mth). The tumor was located in the head in 22 (27%) cases, while the neck area accounted for 53 (65%) cases. General description without precise location was shown in 6 (7%) cases. All patients underwent complete surgical excision. Post surgical recurrence was noted in 6% clinical cases in the analyzed articles.

CONCLUSIONS

Lipoblastoma is characterized by a rapidly growing predominantly adipose mass. The treatment of choice is complete surgical excision. In selected cases when the pathology is hard to reach, as a consequence of the extensive penetration of the mass, we recommend performing the procedure with an interdisciplinary team. Endoscopy assistance and microdebrider significantly facilitated the removal of pathology in the described advanced case of lipoblastoma. This is the only case reported in the pediatric literature of a head and neck lipoblastoma, where due to extensive involvement and location of the disease the cranial nerves V2 and inferior alveolar branch of V3 could not be spared. Long-term follow-up even to 10 years is required because there is a reported tendency for these tumors to recur.

Lipoblastoma Arising in the Head and Neck: A Clinicopathologic Analysis of 20 Cases

BACKGROUND

Lipoblastomas (LPBs) are benign adipocytic neoplasms believed to recapitulate the development of embryonal fat.

METHODS

We investigated the clinicopathologic and immunohistochemical features of 20 lipoblastomas arising in the head and neck in 18 patients.

RESULTS

Patients included 6 males and 12 females (1:2 ratio) with age at diagnosis ranging from 4 months to 28 years. Tumors occurred more commonly in the neck (12, 66.7%) and less commonly in the forehead, scalp, and tongue (2, 11.1%). Tumor size ranged from 1.4 to 6.0 cm (median 5.0 cm). Two patients, a 4-month-old female and 3-year-old male, had local recurrence of neck tumors at 4 months and 3 years after excision, respectively. Microscopically, tumors had a lobulated growth pattern and consisted of adipocytes at varying stages of differentiation. In addition to the classical histologic features, lipoma-like and myxoid variants constituted 45% of cases. Metaplastic elements, including brown fat and cartilage, were identified in two cases.

CONCLUSIONS

LPBs arising in the head and neck region are not uncommon and occurred at a rate of 9% in our cohort. They should be kept in the differential diagnosis when a fatty tumor is encountered in an older child or occurring at an unusual location.

A Giant Compressive Mesenteric Lipoblastoma Initially Suspected to Be Abdominal Malignancy: A Report of a Rare Case in a Nine-Month-Old Infant

Lipoblastoma is a rare benign soft tissue neoplasm rising from embryonic white adipose tissue known as lipoblast that keeps proliferating during the postnatal period. Although lipoblastomas are benign, they often grow rapidly. Most lipoblastomas are asymptomatic at presentation; they can present as a growing painless palpable mass and progressive symptoms of various organ compression depending on localization. A giant mesenteric lipoblastoma is a rare case with only a few cases reported. An infant with large intraabdominal masses may present preoperative diagnostic difficulties. Differential diagnoses are broad and may include sarcomas, germ-cell tumors, lipomas, lymphomas, hepatoblastomas, Wilm's tumors, and neuroblastomas. Thorough clinical, radiological, and pathological investigations are ultimately required to obtain a definitive diagnosis. Regardless of location, the treatment of choice for lipoblastoma is complete surgical resection. All patients should be followed up for a minimum of five years We report a rare case of a giant compressive mesenteric lipoblastoma that was initially suspected as abdominal malignancy in a nine-month-old infant. As physicians, we must always consider the underlying cause as well as the malignant or benign nature of a growing mass to treat the patient appropriately.

Imaging Assessment of Interval Metastasis from Melanoma

Interval metastasis is a particular metastatic category of metastatic localizations in the lymph nodes in patients with melanoma. Interval nodes are generally located at nonregional lymphatic stations placed along the pathway of the spread of melanoma, such as the epitrochlear lymph node station, the popliteal fossa, and the retroareolar station. Imaging techniques for evaluation of patients with interval metastasis from melanoma diseases include ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), lymphoscintigraphy (LS), and positron emission tomography (PET). A literature review was conducted through a methodical search on the Pubmed and Embase databases. The evaluation of lymph node metastases represents a critical phase in the staging and follow-up of melanoma patients. Therefore, a thorough knowledge of the imaging methods available and the interactions between the clinician and the radiologist are essential for making the correct choice for individual patients, for a better management, and to improve treatment and survival.

Lipoblastomas and liposarcomas in paediatric patients: A case series

Lipoblastomas and liposarcomas are rare causes of soft tissue masses in paediatric patients. In this retrospective clinical case series we identified 11 patients from our paediatric database (10 with a lipoblastoma and one with a liposarcoma) who had attended our hospital between 1998 and 2019. The median age of patients with lipoblastoma was 29 months. All lipoblastoma cases were managed with surgical excision and histological examination. The 18-year old patient with liposarcoma presented with a metastatic and unresectable tumour that was unresponsive to chemotherapy and radiation. Our experience demonstrates the importance of differentiating the type of soft tissue mass in children.

[Multivisceral resection of lipoblastoma of four anatomical areas of the head and neck with simultaneous neurotization of the facial muscles in an 8-months child. Clinical case]

The article describes diagnostics and surgical treatment of a rare benign tumor (lipoblastoma) of four anatomical areas of the head and neck in an 8-months child. Diagnostic data, surgical procedure performed using microsurgical techniques and intraoperative neuromonitoring and the patient's condition in the long-term postoperative period are presented. The histological conclusion about the removal of the tumor with negative resection margins suggests favorable prognosis of the disease.